New York City to End Contract With Rikers Health Care Provider

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Mark Peters, the commissioner of the Department of Investigation, at a news conference about a report on the failings of Corizon, the for-profit health provider that New York has relied on for 15 years.CreditAndrew Renneisen for The New York Times

New York City officials have known for years about serious problems with Corizon Health Inc., the for-profit company that oversees medical care at the Rikers Island jail complex.

The latest reminder came on Wednesday, when the city’s Department of Investigation reported that the company had hired doctors and mental health workers with disciplinary problems and criminal convictions, including for murder and kidnapping. It also found that missteps by Corizon employees may have contributed to at least two recent inmate deaths.

At the same time the Investigation Department was detailing these failings in a news conference, Mayor Bill de Blasio announced that he would not renew Corizon’s contract when it expires at the end of the year.

“We have an essential responsibility to provide every individual in our city’s care with high quality health services, and our inmates are no different,” Mr. de Blasio said in a statement.

The decision ends the company’s troubled 15-year history at the city’s jails, but it also highlights the enormous challenge of providing quality health care to the inmates at Rikers.

The city has tried repeatedly to replace the company with a nonprofit hospital or health care provider, but had difficulty persuading anyone even to submit a bid, according to current and former government officials.

Taking Corizon’s place will be the Health and Hospitals Corporation, which oversees New York’s public hospitals, the mayor said. Until now, the hospitals corporation had been reluctant to assume responsibility for medical care at Rikers, current and former officials said. The hospitals corporation is facing a $753 million deficit next year.

Rikers is also an extremely difficult setting to deliver health care in, and the city has long been criticized by public health experts and inmate advocates for failing to spend the money necessary to provide quality care.

The Investigation Department report was also harshly critical of two city agencies that were charged with overseeing Corizon, the Department of Health and Mental Hygiene and the Department of Correction. Investigators discovered a foot-high pile of folders containing 658 fingerprint cards that were intended for background checks, but instead were stacked on a filing cabinet and forgotten for four years.

In a statement, Corizon said that while it respected the mayor’s reform efforts, it strongly disputed the findings by the Investigation Department, blaming the correction and health agencies for any lapses.

“Occasional errors and negative medical outcomes are inevitable in any health care setting, let alone in a highly challenging correctional environment,” the company said. “But our personnel are involved with more than 800,000 inmate encounters a year, and the serious incidents highlighted in this report do not reflect the quality of care provided hundreds of times every day on the island.”

While New York was one of Corizon’s bigger contracts, the corporation, based in Tennessee, remains the largest private provider in the corrections field, overseeing medical care in more than 50 prisons in 27 states.

Corizon — previously known as Prison Health Services — has been repeatedly criticized by the news media and government investigators. In 2001, within three months of taking over the jail contract in New York, it was fined more than $100,000 by the city for failing to meet standards in 30 of 33 quality markers.

The company has been accused by state investigators for medical failures that played a role in up to a dozen deaths at Rikers. In one case that the State Commission of Correction found to “shock the conscience,” an inmate was left dying, untreated for six days while uniformed officers, doctors, mental health clinicians and nurses made 57 visits to his cell without assisting him. Rather than being fired, the Corizon medical director overseeing his care was transferred to a smaller Rikers jail.

City investigators found that for 89 of 185 personnel files of health care workers they reviewed, there was “no evidence that Corizon conducted a candidate background investigation of any kind.” The report said the result was hiring people with serious criminal convictions, including a mental health clinician who had been involved in a robbery that resulted in a stabbing death.

Another clinician who had served 13 years in prison on a kidnapping charge was arrested recently and accused of smuggling a straight-edged razor into Rikers. He was the third Corizon employee in the last year arrested on suspicion of smuggling contraband into the jail.

Anthony E. Shorris, the first deputy mayor, said that beyond Corizon’s track record, the idea of a for-profit health care provider was contrary to the mayor’s philosophy.

“Frankly, contracting out basic public services like the provision of health care to prisoners is not generally our position on things,” Mr. Shorris said. “We have a bias clearly toward public provision of care.”

Mr. Shorris noted that the president of the Health and Hospitals Corporation, Dr. Ram Raju, was particularly well qualified to take over at Rikers, having overseen health care at the Cook County jail in Chicago before coming to New York.

City officials said they were hoping to restore a sense of mission with its jail health care. Medical care at the jails was overseen by Montefiore Hospital from the mid-1970s to the mid-1990s. Several of the doctors at that time were from the National Health Service Corps, a federal program that provided medical care in hard-to-serve areas. The hospital also provided an ethicist to review, among other things, conflicts between health care staff and correction officers.

Dr. Robert Cohen, who was a medical director at Rikers in the 1980s and is now on the New York City Board of Correction, said he hoped the hospitals corporation would be more independent and view its responsibilities to the patient as paramount.

“That could have a dramatic effect on patient care,” he said.

The Correction Department said in a statement that it had “begun implementing steps to improve the vetting of correctional health service provider staff.”

“The department,” it continued, “has already completed background checks of all current health care service employees.”

In its lengthy rebuttal to the city’s report, Corizon criticized investigators for refusing to identify the employees referenced in the report so that the company could conduct an independent investigation. Under the contract, Corizon said, the Correction Department was responsible for conducting background checks. And because of antidiscrimination laws, the statement said, job applicants could not be disqualified solely on the basis of their criminal history.

Mark Peters, the Investigation Department commissioner, disagreed.

“If somebody did 13 years for kidnapping or second-degree murder or serious drug possession, I think they shouldn’t be working at Rikers,” he said.

Among the most glaring problems highlighted in the report was the failure to process the fingerprint cards for job candidates. From 2011 to 2015, cards arrived regularly at the office of Alan Vengersky, the deputy commissioner, who has since retired. He did not return a call for comment left at his home.

Mr. Vengersky’s administrative assistant, who was not named in the report, told investigators that no one seemed to know what to do with the cards, so they were piled neatly on the filing cabinet. “The administrative assistant further stated that neither Vengersky nor any of his staff ever contacted Corizon to inquire why it was sending these fingerprint cards,” the report said.

Corizon continued to charge each prospective employee a $75 processing fee for the cards. Though investigators alerted the Correction Department about the problem in October 2014, it took four months before officials did something about it.

The report said that by the time the agencies took action, the state had switched to electronic fingerprinting and would no longer accept the inked cards.

Correction:

An article on Thursday about a decision by New York City to end its contract with Corizon for health care at the Rikers Island prison complex misstated the job title of Anthony E. Shorris in some editions. He is the first deputy mayor, not Mayor Bill de Blasio’s chief of staff.

Colleen Wright contributed reporting.

A version of this article appears in print on , on Page A20 of the New York edition with the headline: City Cuts Ties With Provider of Health Aid at Rikers Jail. Order Reprints | Today’s Paper | Subscribe

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